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Monday, November 9, 2015

Many have probably heard by now about the Case and Deaton publication, which documents an increase in all-cause mortality among non-Hispanic white aged 45-54, which supposedly goes against the trend for other racial groups and other countries, within that age group.

However, this is incorrect. The fact is that all-cause mortality rates have increased for age groups 25-34 and 35-44 as well, for non-Hispanic whites. How do I know this? By checking the same data that Case and Deaton cited in their paper, the CDC WONDER. The CDC WONDER is stated to be the source used to document the changes in white midlife mortality in their publication. Yet in the same publication, they state:

"The focus of this paper is on changes in mortality and morbidity for those aged 45–54. However, as Fig. 4 makes clear, all 5-y age groups between 30–34 and 60–64 have witnessed marked and similar increases in mortality from the sum of drug and alcohol poisoning, suicide, and chronic liver disease and cirrhosis over the period 1999–2013; the midlife group is different only in that the sum of these deaths is large enough that the common growth rate changes the direction of all-cause mortality."

Their publication thus suggests that mortality rates among non-Hispanic whites did not increase for any age group other than the 45-54 age group. However, this is what I found in the CDC WONDER database. Here is the change in mortality rates per 100,000 people for non-Hispanic whites, among the 25-34 age group:

The relative increase since 1999 is 21%. Yes that's right, 21%. Quite a lot more than the 8.9% relative increase observed for the age group 45-54, during the same period. Yet no one talks about the sharp increase in mortality rates for this age group. Probably because no one knows about it.

Yeah I know, Deaton and Case didn't explicitly state that all-cause mortality rates for non-Hispanic whites increased for the age groups 25-34 or 35-44. They did, however, state that all-cause mortality did not increase for the age group 30-34 (see the aforementioned quote I provided).

In conclusion, the part in the Case and Deaton publication which states that all-cause mortality rates for non-Hispanic whites did not increase for any other age group than 45-54 is, to put it bluntly, WRONG. At least according to the data they used.

If you don't believe me, check the data yourself on CDC WONDER. Also, check Case and Deaton's publication and you will see that they refer to the CDC WONDER data (among others) in their paper.

Also, mortality rates continued to decrease for Hispanics, non-Hispanic blacks, and Asian and Pacific Islanders for all the age groups. This you can check for yourself as well, if you wish to.

P.S. Could someone point this out to Deaton and Case?

Update: Finally got an email response from Deaton. Here is part of the email:

"You are right about the rising mortality rate in the younger group, and our statement that you quote should have been more precise and made it clear that we were referring to the older groups. “Deaton and Case are wrong” seems a little strong though, especially as people will read it to mean that the headline result is wrong, rather than that we made an insufficiently qualified statement. But that is your choice.

The reason we did not want to say much about the younger groups is that their mortality rates are (a) extremely low, so that it is pretty easy for even a small number of deaths to increase the overall mortality rate for them, and (b) their mortality rates have indeed increased not infrequently in the past, for example from AIDS. So it is not such a big deal when their rate goes up. But, as you say, we should have been more precise."

And he notes:

"BTW: the study is Case and Deaton, not Deaton and Case, though you are far from the only one to have made that mistake!"

That's certainly not a mistake I'll make again.I would still argue that the increase for the 25-34 age group is significant, given that even the absolute increase of 21 out of 100,000 people is not much lower than the 34 out of 100,000 people increase for the 45-54 age group (the relative increase is more than twice as large). In addition, almost all of the increase appears to come from poisonings (all of this can be confirmed on CDC WONDER).

Many have probably heard by now about the Case and Deaton publication, which documents an increase in all-cause mortality among non-Hispanic white aged 45-54, which supposedly goes against the trend for other racial groups and other countries, within that age group.

One question that may interest some people then might be how the data looks like for individual states. Well, that is rather easy to find out. Case and Deaton already stated in their publication that the data they used to document the changes in mortality rates for non-Hispanic whites comes from CDC WONDER, so that's also where my data will come from. Without further ado, here are the changes in mortality rates per 100,000 people for non-Hispanic whites aged 45-54, between the years 1999 and 2013:

US average

1999: 381.5 per 100,000

2013: 415.4 per 100,000

Relative change: +8.9%

Alabama

1999: 463.1 per 100,000

2013: 585.8 per 100,000

Relative change: +26.5%

Alaska

1999: 297.9 per 100,000

2013: 351.8 per 100,000

Relative change: +18.1%

Arizona

1999: 421.7 per 100,000

2013: 437.5 per 100,000

Relative change: +3.7%

Arkansas

1999: 465.2 per 100,000

2013: 565.3 per 100,000

Relative change: +21.5%

California

1999: 400.6 per 100,000

2013: 377.2 per 100,000

Relative change: -5.8%

Colorado

1999: 320.4 per 100,000

2013: 341.1 per 100,000

Relative change: 6.5%

Connecticut

1999: 320.4 per 100,000

2013: 310.4 per 100,000

Relative change: -3.1%

Delaware

1999: 391.5 per 100,000

2013: 463.8 per 100,000

Relative change: +18.5%

District of Columbia

1999: 346.6 per 100,000

2013: 134.7 per 100,000

Relative change: -61.1%

Florida

1999: 454.4 per 100,000

2013: 483.2 per 100,000

Relative change: +6.3%

Georgia

1999: 410.1 per 100,000

2013: 470.9 per 100,000

Relative change: +14.8%

Hawaii

1999: 309.3 per 100,000

2013: 345.7 per 100,000

Relative change: +11.8%

Idaho

1999: 328.1 per 100,000

2013: 403.8 per 100,000

Relative change: +23.1%

Illinois

1999: 359.6 per 100,000

2013: 354.8 per 100,000

Relative change: -0.1%

Indiana

1999: 403.7 per 100,000

2013: 458.7 per 100,000

Relative change: +13.6%

Iowa

1999: 313.1 per 100,000

2013: 382.7 per 100,000

Relative change: +22.2%

Kansas

1999: 351.5 per 100,000

2013: 420.2 per 100,000

Relative change: +19.5%

Kentucky

1999: 454 per 100,000

2013: 560.5 per 100,000

Relative change: +23.5%

Louisiana

1999: 445.3 per 100,000

2013: 505.1 per 100,000

Relative change: +13.4%

Maine

1999: 340.8 per 100,000

2013: 361.8 per 100,000

Relative change: +6.1%

Maryland

1999: 357.5 per 100,000

2013: 358.4 per 100,000

Relative change: +less than 0.1%

Massachusetts

1999: 331.1 per 100,000

2013: 326 per 100,000

Relative change: -1.5%

Michigan

1999: 374 per 100,000

2013: 408.8 per 100,000

Relative change: +9.3%

Minnesota

1999: 287.2 per 100,000

2013: 285 per 100,000

Relative change: -0.01%

Mississippi

1999: 467.5 per 100,000

2013: 636.1 per 100,000

Relative change: +36.1%

Missouri

1999: 405 per 100,000

2013: 464.7 per 100,000

Relative change: +14.7%

Montana

1999: 327.4 per 100,000

2013: 386.8 per 100,000

Relative change: +18.1%

Nebraska

1999: 306.7 per 100,000

2013: 341.2 per 100,000

Relative change: +11.2%

Nevada

1999: 506.4 per 100,000

2013: 537.7 per 100,000

Relative change: +6.2%

New Hampshire

1999: 311.3 per 100,000

2013: 336.5 per 100,000

Relative change: +8.1%

New Jersey

1999: 367.1 per 100,000

2013: 342.4 per 100,000

Relative change: -6.7%

New Mexico

1999: 382.1 per 100,000

2013: 455 per 100,000

Relative change: +19.1%

New York

1999: 353 per 100,000

2013: 323.4 per 100,000

Relative change: -8.4%

North Carolina

1999: 386.3 per 100,000

2013: 439.6 per 100,000

Relative change: +13.8%

North Dakota

1999: 274.8 per 100,000

2013: 361.8 per 100,000

Relative change: +31.7%

Ohio

1999: 381.4 per 100,000

2013: 458.5 per 100,000

Relative change: +20.2%

Oklahoma

1999: 467.7 per 100,000

2013: 610.1 per 100,000

Relative change: +30.4%

Oregon

1999: 377.4 per 100,000

2013: 404.3 per 100,000

Relative change: +7.1%

Pennsylvania

1999: 369.1 per 100,000

2013: 385.2 per 100,000

Relative change: +4.4%

Rhode Island

1999: 344.6 per 100,000

2013: 426.8 per 100,000

Relative change: +23.9%

South Carolina

1999: 439.3 per 100,000

2013: 512.4 per 100,000

Relative change: +16.6%

South Dakota

1999: 337.1 per 100,000

2013: 323.1 per 100,000

Relative change: -4.2%

Tennessee

1999: 454.3 per 100,000

2013: 568.2 per 100,000

Relative change: +25.1%

Texas

1999: 396.4 per 100,000

2013: 441.6 per 100,000

Relative change: +11.4%

Utah

1999: 339.7 per 100,000

2013: 341.2 per 100,000

Relative change: +less than 0.1%

Vermont

1999: 329.3 per 100,000

2013: 353.1 per 100,000

Relative change: +7.2%

Virginia

1999: 332.2 per 100,000

2013: 365.6 per 100,000

Relative change: +10.1%

Washington

1999: 329.2 per 100,000

2013: 358.6 per 100,000

Relative change: +8.9%

West Virginia

1999: 444.3 per 100,000

2013: 627.1 per 100,000

Relative change: +41.1%

Wisconsin

1999: 315.7 per 100,000

2013: 333.4 per 100,000

Relative change: +5.6%

Wyoming

1999: 374.8 per 100,000

2013: 436.8 per 100,000

Relative change: +16.5%

Note: The data comes from CDC WONDER, which was used by Deaton and Case to document the mortality rates for non-Hispanic whites. This is explicitly stated in their publication. If you don't believe me on the data, check for yourself; the link is provided.